PHRM3011 Lecture Notes - Lecture 17: Fenofibrate, Calcitriol, Colchicine

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12 Aug 2018
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Performed for cyclosprorines, tacrolimus, sirolimus and everolimus. Want a measure of overall drug exposure. Tdm (therapeutic drug monitoring) maintaining levels within a pre-defined range. Tci (target concentration intervention) aiming for a particular level in a given individual. 1 in 3 people are at increased risk of ckd stage 5 = dialysis/transplant stage 3a = lost 50% of kidney function. Metformin in ckd (renally excreted) cease if egfr = <30ml/min. Use with extreme caution if 30-60ml/min it increases production and decreases clearance of lactate impaired ability of liver to remove lactate as ph falls. Hepatic conversion of lactate to glucose impeded. Pts should stop metformin if they become dehydrated. Actual egfr = normalised egfr x actual bsa / 1. 73. Not renally excreted clear benefit in therapy. Metastatic calcification joints, blood vessles, heart valves, eyes, skin (turning in bones due such high levels of ca2+) Hyperphosphataemia start phosphate binder (1 tablet with each meal)

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